49-year-old woman has central retinal vein occlusion right eye with fluctuating vision and then recently her vision declined and she developed macular edema. I was worried about her angle and you were kind enough to do a peripheral iridotomy and I am dilating her today. Her vision is still poor. VISUAL ACUITY: OD 20/100. IOP: OD 20. There is a peripheral iridotomy, lens is clear, there is no rubeosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is 2+ optic nerve edema, 3+ cystoid macular edema. The retinal veins are dilated in all 4 quadrants. The photos confirm clinical findings. Fluorescein angiogram shows some substantial delay in the venous circulation time with no non-profusion. IMPRESSION: 1. PERFUSED CENTRAL RETINAL VEIN OCCLUSION RIGHT EYE. 2. MACULAR EDEMA IN THE RIGHT EYE. DISCUSSION: I explained to the patient that with intravitreal Kenalog there is about an 80% chance of drying up the macula and improving the vision. There is a risk of cataract and glaucoma and a very low risk of infection. I injected the eye today without difficulty with the Kenalog.